In defense of variation: A neurosurgeon takes on Atul Gawande
In 2012, celebrated surgeon-cum-writer Atul Gawande penned an incisive essay for the New Yorker entitled “Big Med.” Deliberately provocative, yet disarmingly reasoned, it suggests that American health care should borrow management practices from the Cheesecake Factory.
To set the stage, Gawande paints an unflattering picture of the status quo: medical costs are too high, quality is not reliable, service is often poor, and physicians differ widely in their approaches and outcomes …